Provider Demographics
NPI:1023045291
Name:KLEINBAUER, JULIE L (CRNP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:L
Last Name:KLEINBAUER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KLEINBAUER
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:CREDENTIALS DEPT
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-2770
Practice Address - Country:US
Practice Address - Phone:570-271-6396
Practice Address - Fax:570-271-5840
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN303356L163W00000X
PASP011449363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARO227442Medicare PIN
P80007Medicare UPIN